CULLEN

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FIRST LINES OF THE PRACTICE OF PHYSIC.
By William Cullen, M.D., late Professor of the Practice of Physic in he University of Edinburgh, 1791.
Date of Preface, 1783.

I. Mania.-Restraint calms passion: strait waistcoast best; should never be in a horizontal position. Confinement, and as great a freedom as possible, from all objects of sight and sound. Fear. Low diet. Blood should be drawn from the arm "ad deliquium animi," except where the disease has subsisted for some time. Where there is a frequency, or even fulness ofthe pulse, or any marks of an increased impetus of the blood in the vessels of the head, blood-letting is a proper, and even a necessary remedy. Cooling laxatives, particularly tartrate of potassa, which he also recommends in melancholia. No experience in vomiting. Blisters, in recent cases, induce sleep; in old, of no service. Cold water to head; warm bathing rather hurtful. In some cases, as producing collapse of nervous excitement, used opium in large doses with success, and sleep was induced; in others, fear of inflammation, and the doubt, as depending on organic lesion, whether it would not be superfluous, caused him "not to push this remedy to the extent that might be neceseary to make an entire cure." Camphor inefficacious. Recommends labour, from theory; journeys, from experience.

II. Melancholia. - In melancholia. believes purgatives useful, as counteracting the constant costiveness. Cold bathing hardly ever proper to be used; but warm, from the rigidity. No opiates, except in cases like mania in their excitement; and low diet in the same. In his " Clinical Lectures," two cases of melancholy. 1st. Cold shiverings, to a degree of fever, succeeded by melancholy: bleeding and blistering seemed advantageous. If cause known, treat that, and thus remove disease. 2d. Treated as a gouty patient: fits of melancholy alternating with gout.